Payer-Specific Service

Humana Credentialing & Enrollment

Specialized credentialing and enrollment services for Humana commercial, Medicare Advantage, and Medicaid plans. Get in-network with Humana faster and expand your patient base.

800+ Humana Providers

45-60 Days Average

98% Approval Rate

Start Humana Enrollment Free Humana Consultation

Humana Preferred Partner

Complete Humana Enrollment

Commercial, Medicare Advantage, and Medicaid plan credentialing

Our Process

Humana Credentialing Made Efficient

Our streamlined 3-step process ensures your Humana enrollment is completed accurately and quickly.

CAQH & Availity Setup

We ensure your CAQH ProView profile is complete and attested, and set up your Availity provider portal access.

Humana Application Submission

We prepare and submit complete credentialing applications through Humana's provider enrollment portal with all required documentation.

Follow-Up & Contracting

We track application status, respond to Humana requests, and assist with contract review and signature upon approval.

Humana Plans We Cover

All Humana Plan Types

We credential providers for all Humana commercial, Medicare, and Medicaid products.

Humana Commercial

PPO, HMO, EPO, and POS plans for employer groups

Humana Medicare Advantage

HMO, PPO, PFFS, and SNP plans

Humana Healthy Horizons

Medicaid managed care programs

Humana Exchange Plans

ACA Marketplace individual and family plans

Humana Military (TRICARE)

TRICARE East Region network

Humana Vision

Vision care plans and optometry networks

Humana Dental

Dental PPO and prepaid plans

Humana Pharmacy

Medicare Part D and prescription plans

Core Requirements

Humana Credentialing Essentials

We ensure all Humana credentialing requirements are met with precision.

CAQH Attestation

Current CAQH profile with recent attestation (within 120 days)

State Medical License

Active, unrestricted license in practicing state

DEA Registration

Valid DEA certificate for controlled substances

Board Certification

ABMS or AOA board certification status

Malpractice Insurance

Minimum coverage per Humana requirements

Work History

Complete 5-year work history with gap explanations

W-9 Form

Current IRS W-9 for tax identification

Background Screening

OIG, SAM, and NPDB clearances

Why Choose Us

Humana Credentialing Excellence

We understand Humana's specific credentialing requirements and processes.

Availity Portal Expertise

Deep familiarity with Availity, Humana's primary provider portal for credentialing and claims.

Error-Free Applications

We ensure applications meet all Humana-specific requirements to prevent processing delays.

Medicare Advantage Focus

Specialized expertise in Humana's extensive Medicare Advantage credentialing requirements.

Recredentialing Support

Ongoing monitoring and management of Humana's 3-year recredentialing cycle.

FAQ

Humana Credentialing Questions Answered

Clear answers to common questions about Humana credentialing.

How long does Humana credentialing take?

Humana credentialing typically takes 45-90 days from application submission to effective date. Our expedited process helps minimize delays.

Does Humana require CAQH?

Yes, Humana requires providers to maintain a current, attested CAQH ProView profile. Re-attestation is required every 120 days.

What is Availity and do I need it?

Availity is Humana's primary provider portal for credentialing, claims submission, and eligibility verification. We help set up and manage your Availity account.

Does Humana require site visits?

Site visits may be required for certain specialties, particularly for Medicare Advantage network participation. We help prepare you for any required inspections.

What is Humana's recredentialing cycle?

Humana requires recredentialing every 3 years. We track your cycle and manage the complete recredentialing process.

Can I join Humana Medicare Advantage separately?

Yes, Humana Medicare Advantage requires separate credentialing from commercial plans. We manage both processes simultaneously for complete coverage.

Does Humana credential non-physician providers?

Yes, Humana credentials Nurse Practitioners, Physician Assistants, and other advanced practice providers. Requirements vary by state and specialty.

What if I have multiple practice locations?

Each practice location must be separately credentialed with Humana. We manage the enrollment process for all your locations.

Ready to Join Humana's Network?

Let our Humana credentialing experts get you in-network quickly and start seeing Humana patients sooner.

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